The Role of Curcumin in Reducing Antituberculosis Drug-Induced Hepatotoxicity: A Literature Review

Abstract

Antituberculosis drug-associated liver injury may interrupt tuberculosis treatment. This structured narrative review examines curcumin as a potential hepatoprotective adjunct while distinguishing mechanistic findings from evidence of clinical benefit. Four focal publications were identified in the documented literature review: one retrospective observational study of Curcuma-tablet use and three secondary reviews. Two underlying experimental reports were additionally traced to clarify the mechanisms discussed in those reviews; they were not counted as independently screened publications. Preclinical findings suggest modulation of oxidative stress and apoptosis, protoporphyrin IX and ferrochelatase, and SIRT1/PGC-1α/NRF1 signaling. A retrospective study involving 60 patients reported lower mean AST, ALT, and bilirubin values associated with a Curcuma preparation, but its design and incompletely characterized formulation do not establish a curcumin-specific treatment effect. Interpretation is limited by overlapping reviews, preclinical evidence, and sparse human data. Curcumin remains a research candidate rather than an established intervention for antituberculosis drug-induced hepatotoxicity. Controlled clinical studies are needed to determine efficacy, dosage, formulation, safety, and potential drug interactions.